Lowenstein Steven R, Fernandez Genaro, Crane Lori A
Division of Emergency Medicine, Box B-215, University of Colorado School of Medicine, 4200 East Ninth Avenue, Denver, Colorado 80262, USA.
BMC Med Educ. 2007 Oct 14;7:37. doi: 10.1186/1472-6920-7-37.
Medical school faculty are less enthusiastic about their academic careers than ever before. In this study, we measured the prevalence and determinants of intent to leave academic medicine.
A 75-question survey was administered to faculty at a School of Medicine. Questions addressed quality of life, faculty responsibilities, support for teaching, clinical work and scholarship, mentoring and participation in governance.
Of 1,408 eligible faculty members, 532 (38%) participated. Among respondents, 224 (40%; CI95: 0.35, 0.44) reported that their careers were not progressing satisfactorily; 236 (42%; CI95: 0.38, 0.46) were "seriously considering leaving academic medicine in the next five years." Members of clinical departments (OR = 1.71; CI95: 1.01, 2.91) were more likely to consider leaving; members of inter-disciplinary centers were less likely (OR = 0.68; CI95: 0.47, 0.98). The predictors of "serious intent to leave" included: Difficulties balancing work and family (OR = 3.52; CI95: 2.34, 5.30); inability to comment on performance of institutional leaders (OR = 3.08; CI95: 2.07, 4.72); absence of faculty development programs (OR = 3.03; CI95: 2.00, 4.60); lack of recognition of clinical work (OR = 2.73; CI95: 1.60, 4.68) and teaching (OR = 2.47; CI95: 1.59, 3.83) in promotion evaluations; absence of "academic community" (OR = 2.67; CI95: 1.86, 3.83); and failure of chairs to evaluate academic progress regularly (OR = 2.60; CI95: 1.80, 3.74).
Faculty are a medical school's key resource, but 42 percent are seriously considering leaving. Medical schools should refocus faculty retention efforts on professional development programs, regular performance feedback, balancing career and family, tangible recognition of teaching and clinical service and meaningful faculty participation in institutional governance.
医学院教师对其学术生涯的热情比以往任何时候都低。在本研究中，我们测量了打算离开学术医学领域的比例及其决定因素。
对一所医学院的教师进行了一项包含75个问题的调查。问题涉及生活质量、教师职责、教学支持、临床工作与学术研究、指导以及参与管理等方面。
在1408名符合条件的教师中，532人（38%）参与了调查。在受访者中，224人（40%；95%置信区间：0.35，0.44）表示他们的职业发展不尽如人意；236人（42%；95%置信区间：0.38，0.46）“正在认真考虑在未来五年内离开学术医学领域”。临床科室的成员（比值比=1.71；95%置信区间：1.01，2.91）更有可能考虑离开；跨学科中心的成员则可能性较小（比值比=0.68；95%置信区间：0.47，0.98）。“有强烈离开意愿”的预测因素包括：难以平衡工作与家庭（比值比=3.52；95%置信区间：2.34，5.30）；无法对机构领导的表现发表意见（比值比=3.08；95%置信区间：2.07，4.72）；缺乏教师发展项目（比值比=3.03；95%置信区间：2.00，4.60）；在晋升评估中临床工作（比值比=2.73；95%置信区间：1.60，4.68）和教学（比值比=2.47；95%置信区间：1.59，3.83）未得到认可；缺乏“学术共同体”（比值比=2.67；95%置信区间：I.86，3.83）；以及系主任未能定期评估学术进展（比值比=2.60；95%置信区间：1.80，3.74）。
教师是医学院的关键资源，但42%的教师正在认真考虑离开。医学院应将留住教师的努力重新聚焦于专业发展项目、定期的绩效反馈、平衡职业与家庭、对教学和临床服务的切实认可，以及教师有意义地参与机构管理。
